{"title":"阿戈美拉汀治疗单一复发性非精神病性抑郁症的经验","authors":"L. A. Ivanova, A. Kovaleva, N. O. Sitnikova","doi":"10.14412/2074-27112023-4-24-30","DOIUrl":null,"url":null,"abstract":"Therapy of depression is a current problem in psychiatry. Agomelatine is not inferior to other modern drugs in terms of antidepressant efficacy (response and remission rates) and is characterized by the best tolerability.Objective: to evaluate the efficacy and safety of agomelatine in the treatment of nonpsychotic depression with a single and recurrent course.Material and methods. Patients (n=37) with a current depressive episode (DE; F32 according to ICD-10), mean age 41.2±2.07 years, were studied. Clinical psychopathological and psychometric methods were used in the study (Hamilton Hospital Depression Scale – HAMD-17; Spielberger–Khanin Anxiety Self-Assessment Scale, Sheehan Anxiety Scale, Clinical Global Impression Scale – CGI-I). A single DE was diagnosed in 62.2% of patients, and recurrent depressive disorder in 37.8%. Stress-related onset of current DE was found in 56.8% of cases, autochthonous in 43.2%.Results. 94.6% of patients were responders, including 68.6% who went into remission. A statistically significant decrease in scores on the HAMD-17 scale was noted in the remission group from the 7th day of agomelatine therapy (p<0.05), in the responder group – from the 14th day of therapy (p<0.05). According to the Sheehan scale, a statistically significant decrease in scores was noted at the end of the first week of therapy (p<0.05), according to the Spielberger–Khanin scale – in the second week (p<0.05) in all patients. According to the CGI-I scale, the condition at the end of therapy improved in 57.1% of patients, significantly in 42.9%. Clinical predictors of therapeutic response in patients with remission included significantly higher frequency of a single DE (p<0.02), moderate severity of current depression (p<0.02), dizziness among autonomic disorders (p<0.01), a significantly lower representation of the melancholic type of depression (p<0.05), a symptom of a gloomy and pessimistic vision of the future (p<0.05), sleep disturbances (p<0.04), a factor of personal significance in the form of a threat in patients with stress-provoked onset of the current DE (p<0.05).Adverse events occurred in the first week of treatment with agomelatine in 14.3% of cases (nausea – 8.6%, headache and dizziness – 2.9% each), they were mild and did not require discontinuation of the drug. Two patients taking agomelatine at a dose of 50 mg discontinued the study: in one case persisted social phobia, increased fatigue, motor retardation, and persistent modern insomnia; in the other case – a pronounced senestoalgic syndrome with cerebral localization.Conclusion. Agomelatine therapy has been shown to be highly effective and well tolerated in nonpsychotic depression.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"125 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Experience with agomelatine therapy for non-psychotic depression with a single and recurrent course\",\"authors\":\"L. A. Ivanova, A. Kovaleva, N. O. Sitnikova\",\"doi\":\"10.14412/2074-27112023-4-24-30\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Therapy of depression is a current problem in psychiatry. Agomelatine is not inferior to other modern drugs in terms of antidepressant efficacy (response and remission rates) and is characterized by the best tolerability.Objective: to evaluate the efficacy and safety of agomelatine in the treatment of nonpsychotic depression with a single and recurrent course.Material and methods. Patients (n=37) with a current depressive episode (DE; F32 according to ICD-10), mean age 41.2±2.07 years, were studied. Clinical psychopathological and psychometric methods were used in the study (Hamilton Hospital Depression Scale – HAMD-17; Spielberger–Khanin Anxiety Self-Assessment Scale, Sheehan Anxiety Scale, Clinical Global Impression Scale – CGI-I). A single DE was diagnosed in 62.2% of patients, and recurrent depressive disorder in 37.8%. Stress-related onset of current DE was found in 56.8% of cases, autochthonous in 43.2%.Results. 94.6% of patients were responders, including 68.6% who went into remission. A statistically significant decrease in scores on the HAMD-17 scale was noted in the remission group from the 7th day of agomelatine therapy (p<0.05), in the responder group – from the 14th day of therapy (p<0.05). According to the Sheehan scale, a statistically significant decrease in scores was noted at the end of the first week of therapy (p<0.05), according to the Spielberger–Khanin scale – in the second week (p<0.05) in all patients. According to the CGI-I scale, the condition at the end of therapy improved in 57.1% of patients, significantly in 42.9%. Clinical predictors of therapeutic response in patients with remission included significantly higher frequency of a single DE (p<0.02), moderate severity of current depression (p<0.02), dizziness among autonomic disorders (p<0.01), a significantly lower representation of the melancholic type of depression (p<0.05), a symptom of a gloomy and pessimistic vision of the future (p<0.05), sleep disturbances (p<0.04), a factor of personal significance in the form of a threat in patients with stress-provoked onset of the current DE (p<0.05).Adverse events occurred in the first week of treatment with agomelatine in 14.3% of cases (nausea – 8.6%, headache and dizziness – 2.9% each), they were mild and did not require discontinuation of the drug. Two patients taking agomelatine at a dose of 50 mg discontinued the study: in one case persisted social phobia, increased fatigue, motor retardation, and persistent modern insomnia; in the other case – a pronounced senestoalgic syndrome with cerebral localization.Conclusion. Agomelatine therapy has been shown to be highly effective and well tolerated in nonpsychotic depression.\",\"PeriodicalId\":19252,\"journal\":{\"name\":\"Neurology, neuropsychiatry, Psychosomatics\",\"volume\":\"125 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-08-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurology, neuropsychiatry, Psychosomatics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14412/2074-27112023-4-24-30\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurology, neuropsychiatry, Psychosomatics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14412/2074-27112023-4-24-30","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Experience with agomelatine therapy for non-psychotic depression with a single and recurrent course
Therapy of depression is a current problem in psychiatry. Agomelatine is not inferior to other modern drugs in terms of antidepressant efficacy (response and remission rates) and is characterized by the best tolerability.Objective: to evaluate the efficacy and safety of agomelatine in the treatment of nonpsychotic depression with a single and recurrent course.Material and methods. Patients (n=37) with a current depressive episode (DE; F32 according to ICD-10), mean age 41.2±2.07 years, were studied. Clinical psychopathological and psychometric methods were used in the study (Hamilton Hospital Depression Scale – HAMD-17; Spielberger–Khanin Anxiety Self-Assessment Scale, Sheehan Anxiety Scale, Clinical Global Impression Scale – CGI-I). A single DE was diagnosed in 62.2% of patients, and recurrent depressive disorder in 37.8%. Stress-related onset of current DE was found in 56.8% of cases, autochthonous in 43.2%.Results. 94.6% of patients were responders, including 68.6% who went into remission. A statistically significant decrease in scores on the HAMD-17 scale was noted in the remission group from the 7th day of agomelatine therapy (p<0.05), in the responder group – from the 14th day of therapy (p<0.05). According to the Sheehan scale, a statistically significant decrease in scores was noted at the end of the first week of therapy (p<0.05), according to the Spielberger–Khanin scale – in the second week (p<0.05) in all patients. According to the CGI-I scale, the condition at the end of therapy improved in 57.1% of patients, significantly in 42.9%. Clinical predictors of therapeutic response in patients with remission included significantly higher frequency of a single DE (p<0.02), moderate severity of current depression (p<0.02), dizziness among autonomic disorders (p<0.01), a significantly lower representation of the melancholic type of depression (p<0.05), a symptom of a gloomy and pessimistic vision of the future (p<0.05), sleep disturbances (p<0.04), a factor of personal significance in the form of a threat in patients with stress-provoked onset of the current DE (p<0.05).Adverse events occurred in the first week of treatment with agomelatine in 14.3% of cases (nausea – 8.6%, headache and dizziness – 2.9% each), they were mild and did not require discontinuation of the drug. Two patients taking agomelatine at a dose of 50 mg discontinued the study: in one case persisted social phobia, increased fatigue, motor retardation, and persistent modern insomnia; in the other case – a pronounced senestoalgic syndrome with cerebral localization.Conclusion. Agomelatine therapy has been shown to be highly effective and well tolerated in nonpsychotic depression.